ABSTRACT
Musculoskeletal infections in children present a diagnostic challenge because they
are difficult to recognize in the early stages of the disease and can be confused
with other pathology such as tumors or trauma. The severity of disease may be associated
with the primary tissue of involvement with bone greater than joint, greater than
muscle, greater than soft tissue. The incidence of musculoskeletal infection is higher
in infants and young children, and risk factors include premature birth, umbilical
catheterization, urinary tract infection, immunodeficiency, and other preexisting
disease. Neonates are at greater risk for infection with less virulent organisms due
to immaturity of the immune system. The epidemiology of musculoskeletal infection
is evolving, and the incidence of musculoskeletal infections in children, especially
gram-positive infections, are increasing. Staphylococcus aureus continues to be the leading cause of musculoskeletal infection in children, and the
emergence of resistant bacteria such as methicillin-resistant S. aureus is associated with a higher rate of complications. Atypical infections such as tuberculosis
have also shown resurgence in the last few decades, whereas other infections such
as Haemophilus influenzae are much less prevalent due to widespread immunization. Recent advances in earlier
diagnosis and treatment help to reduce complications. However, even when musculoskeletal
infection is successfully treated, there may be significant long-term effects on growth.
KEYWORDS
Osteomyelitis - pediatric - musculoskeletal - infection
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Marilyn RansonM.D.
Department of Diagnostic Imaging, The Hospital for Sick Children
555 University Ave., Toronto, Ontario, Canada M5G 1X8
eMail: marilyn.ranson@sickkids.ca
